The association between dietary diversity and development among children under 24 months in rural Uganda: Analysis of a cluster-randomised maternal education trial.

OBJECTIVE To assess the association between dietary diversity and development among children under 24-months in rural Uganda; and to establish other factors that could be associated with development among these children. DESIGN A secondary data analysis of a cluster-randomised controlled maternal education trial (n 511) was conducted on a sub-sample of 385 children. We used adjusted odds ratios (AOR) to assess the associations of dietary diversity scores (DDS) and other baseline factors assessed at 6-8 months with child development domains (communication, fine-motor, gross-motor, personal-social and problem-solving) at 20-24 months of age. SETTING Rural areas in Kabale and Kisoro districts of south-western Uganda. PARTICIPANTS Children under 24-months. RESULTS After multivariable analysis, DDS at 6-8 months were positively associated with normal fine-motor skills development at 20-24 months (AOR=1.18; 95% CI: 1.01, 1.37; p=0.02). No significant association was found between DDS and other development domains. Children who were not ill at 6-8 months had higher odds of developing normal communication (AOR=1.73; 95% CI: 1.08, 2.77) and gross-motor (AOR=1.91; 95% CI: 1.09, 3.36) skills than sick children. Girls had lower odds of developing normal gross-motor skills compared to boys (AOR=0.58; 95% CI: 0.33, 0.98). Maternal/caregiver nutritional education intervention was positively associated with development of gross-motor, fine-motor and problem-solving skills (p-values < 0.05). CONCLUSIONS We found an association between child DDS at 6-8 months and improvement in fine motor skills development at 20-24 months. Child illness status, maternal/caregiver nutritional education intervention and sex were other significant baseline predictors of child development at 20-24 months.